SIU Desk Adjuster

We are seeking a detail-oriented and analytical SIU Desk Adjuster to join our Special Investigations Unit.

The SIU Desk Adjuster will be responsible for investigating suspicious or potentially fraudulent insurance claims from a desk-based setting.

This role involves analyzing claim data, conducting research, coordinating with field investigators, and collaborating with internal and external stakeholders to identify fraud indicators and support the resolution of complex claims.

The ideal candidate will have strong investigative skills, a keen eye for detail, and a commitment to maintaining the integrity of the claims process.

* Review and analyze insurance claims to identify red flags, inconsistencies, or patterns indicative of potential fraud * Conduct desk-based investigations, including gathering and reviewing documentation, policy details, and claimant information to support fraud detection * Utilize internal databases, public records, and third-party tools to verify information and uncover discrepancies in claims * Work closely with field investigators, claims adjusters, legal counsel, and law enforcement to build comprehensive case files and support fraud investigations * Prepare detailed reports, summaries, and recommendations based on investigative findings for management and legal teams * Ensure all investigations adhere to company policies, state regulations, and industry standards regarding privacy and ethics * Maintain clear and professional communication with claimants, witnesses, and other parties while protecting sensitive information * Bachelor's Degree in Criminal Justice, related field, or equivalent experience * Minimum of 1 year of experience in insurance claims handling, fraud investigation, or a related field * Prior experience in an SIU or desk-based investigative role is preferred * Certified Fraud Examiner (CFE), Certified Insurance Fraud Investigator (CIFI), or similar credentials are a plus * Strong analytical and critical thinking skills to evaluate complex data and identify fraud indicators * Excellent written and verbal communication skills for report writing and stakeholder interaction * Proficiency in claims management software, Microsoft Office Suite, and investigative tools